Abstract
Abstract: :
Purpose: The aim of this study was to describe the characteristics of autofluorescence of macular holes and correlations with OCT patterns. Methods: We studied 17 consecutive patients (7 M and 10 F: a total of 19 eyes, age 60–79 y) from March 2003 through November 2003, scheduled for vitrectomy with ICG–assisted ILM peeling: four had pseudoholes and fifteen had idiopathic full thickness macular holes (FTMH), two of them with Gass stage 2 and thirteen with Gass stages 3–4. All patients underwent ophthalmological examination before and after surgery, including autofluorescence imaging (Heidelberg Retinal Angiograph) and Optical Coherence Tomography (OCT3 Zeiss Instrument). Results: According to Andrea Von Ruckmann et al. (Br J Ophthalmol 98;82:346–351), full thickness macular holes had bright autofluorescence, while pseudoholes had pale autofluorescence and shade edges. OCT demonstrated on FTMH a complete neurosensory retinal defect, a cuff of retinal dethachment around the hole, thickened edges and intraretinal cysts. The cuff around the hole showed a decreased fluorescence. Pseudoholes demonstrated a partial thickness inner retinal defect but retinal pigment epithelial layer was not denuded. The presence of a preretinal operculum was demonstrated in two cases by OCT. Only in one of them we found a "shadow cast" inside the bright fluorescence, probably due to the distance from the retinal layer. When complete closure of the hole was obtained, autofluorescence was no longer visible and OCT demonstrated a restoration of a normal retinal layer above the foveal region. In case of atrophic closure there was an interruption in the continuity of foveal tissue on OCT images and a slight autofluorescence persisted. Conclusion: Autofluorescence of macular holes is generated by trasmission of fluorescence of lipofuscin inside retinal pigment epithelium. From this experience we realised there is a great correlation between autofluorescence features and OCT patterns, which makes autofluorescence imaging a useful aid in the diagnosis and follow–up of macular holes when OCT is not available.
Keywords: imaging/image analysis: clinical • macular holes • vitreoretinal surgery